Effects of topical ketorolac tromethamine 0.45% on intraoperative miosis and prostaglandin E2 release during femtosecond laser-assisted cataract surgery.

Abstract

Purpose: To determine the effects of topical 0.45% ketorolac tromethamine on intraoperative miosis and prostaglandin E2 (PGE2) release during femtosecond laser–assisted cataract surgery. Setting: Seoul St. Mary's Hospital, Seoul, Korea. Design: Prospective case series. Methods: The study comprised the following 3 groups: conventional cataract surgery without topical NSAIDs (conventional group); femtosecond laser–assisted cataract surgery with preoperative topical ketorolac tromethamine 0.45%(femtosecond NSAID group), and femtosecond laser–assisted cataract surgery without topical NSAIDs (femtosecond no-NSAID group). To measure the aqueous humor PGE2 concentration, a 100 mL aqueous humor sample was collected from the anterior chamber after femtosecond laser pretreatment. The PGE2 concentration was measured using an enzyme immunoassay. Results: Topical ketorolac tromethamine 0.45%led to a significant reduction in intraoperative miosis in the femtosecond NSAID group compared with the femtosecond no-NSAID group (P < .001). Absolute and relative reductions in pupil area in the femtosecond NSAID group were significantly lower than in the femtosecond no-NSAID group (P Z .019 and P Z .007, respectively). The mean aqueous humor PGE2 concentrations were 893.60 pg/mL G 843.10 (SD) in the conventional group, 1911.43 G 1178.63 pg/mL in the femtosecond NSAID group, and 743.63 G 927.46 pg/mL in the femtosecond no-NSAID group (P < .001, conventional versus femtosecond NSAID and femtosecond NSAID versus femtosecond no NSAID; P > .05, conventional versus femtosecond NSAID). Conclusion: Preoperative topical ketorolac tromethamine 0.45% reduced miosis induced by femtosecond laser pretreatment and inhibited aqueous humor PGE2 elevation.